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AUBF > M1: Urine Sediments (Part 1) > Flashcards

M1: Urine Sediments (Part 1) Flashcards

Red Blood Cells, White Blood Cells, Epithelial Cells

1
Q

Described as colorless, non-nucleated, smooth biconcave
disk with average size of 7 um (6-8) in diameter

A

Red Blood Cell

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2
Q

Average size of red blood cell?

A

7 um (6-8) in diameter

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3
Q

Red Blood Cells

In concentrated or hyperstherunic urine, there is a presence of what?

A

hypertonic and crenated cell

small cell with crinkled border or spheres with spicules

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4
Q

Red Blood Cells

In dilute or hyposthenuria urine, there is a presence of what?

A

presence of hypotonic and ghost/shadow cell

faint, colorless circle - intact cell with no hemoglobin

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5
Q

RBCs are frequently confused with what type of cells?

A

WBCs, yeast cells, air bubbles, and oil droplets

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6
Q

T or F: WBCs and yeast cells dissolve in 2 to 5% acetic acid while RBCs do not

A

False

teh baliktad yan wtf

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7
Q

Yeast cells differ from RBCs because they exhibit what?

A

Budding

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8
Q

Oil droplets and air bubbles differ from RBCs because?

A

They have irregular sizes and are highly refractile when the fine adjustment is focused up and down

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9
Q

What is the reference range for RBCs?

A

0 - 2 RBC/hpf

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10
Q

RBCs with protrusion or fragmentation is known as?

A

Dysmorphic RBC

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11
Q

This type of RBC indicates renal or glomerular bleeding

A

Dysmorphic RBC

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12
Q

What stain is used for dysmorphic RBCs?

A

Wright’s Stain

hypochromic, presence of cellular blebs and protrusions

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13
Q

Dysmorphic RBC

Described as rounded outgrowth on the surface of a cell

A

Blebs :p

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14
Q

Clinical Significance of RBCs in Urine

What are the clinical significances of RBCs in urine?

Familiarize yourselves na lang fleece, thank you mwa.

A
  1. Glomerular membrane damage (glomerulonephritis
  2. Vascular injury with the genitourinary tract
  3. Renal Calculi
  4. Malignancy
  5. Hematuria (Macroscopic and Microscopic)
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15
Q

Clinical Significance of RBCs in Urine

Increased RBCs + RBC casts mean?

A

Bleeding is renal in origin

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16
Q

Clinical Significance of RBCs in Urine

Increased RBCs + no RBC casts mean?

A

Bleeding site is distal to the kidney

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17
Q

Clinical Significance of RBCs in Urine

Undistorted RBCs and uniform appearance mean?

A

Non-glomerular bleeding

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18
Q

T or F: The presence of not only RBCs but also hyaline, granular, and RBC casts may be seen following strenous exercises.

A

True the fire

Non-pathologic and disappear after rest.

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19
Q

What are the two types of hematuria?

A

Macroscopic and microscopic

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20
Q

Hematuria

  • Urine appears cloudy with a red to brown color
  • Reported in terms of greater than 100 per hpf
  • Frequently associated with advanced glomerular damage
A

Macroscopic hematuria

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21
Q

Hematuria

  • Critical to the early diagnosis of glomerular disorders and malignancy of the urinary tract and to tract the presence of renal calculi
A

Microscopic hematuria

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22
Q

T or F: RBCs are larger than WBCs

A

F

teh amaccana

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23
Q

What is the average size of WBCs?

A

12 um (10-14) in diameter

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24
Q

What is yje predominant WBC found in urine sediment?

A

Neutrophil

Much easier to identify because they contain granules and multilobed nuclei.

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25
Q

What type of cells are WBCs frequently confused with?

A

RBCs and RTEs (renal tubular epithelial cells)

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26
Q

What is the reporting of WBCs?

A

average/10 hpfs

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27
Q

What is the normal value of WBCs?

A

0 - 5 WBCs/hpf

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28
Q

T or F: WBCs lyse rapidly in dilute alkaline urine and begin to lose nuclear detail.

A

T

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29
Q

Neutrophils exposed to dilute or hypotonic urine absorb water and swell

A

Glitter Cells

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30
Q

Glitter Cells

What type of movement within granules is observed within WBCs that produce a sparkling appearance?

A

Brownian Movement

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31
Q

Glitter Cells

What stain is used to stain the glitter cells light blue as opposed to the violet color usually seen on neutrophils?

A

Sternheimer-Malbin stain

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32
Q

T or F: Glitter cells are no pathologic significance

A

T

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33
Q

Clinical Significance of WBCs in Urine

An increase in WBCs that indicates the presence of an infection or inflammation in the genitourinaary system is called?

A

Pyuria

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34
Q

If there is a presence of WBC cast, it indicates what?

A

Infection or inflammation is renal in origin

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35
Q

Clinical Significance of Neutrophils in Urine

What are the bacterial infections associated with WBCs in urine?

Familiarize ulit hehe mwa.

A
  1. Pyelonephritis
  2. Cystitis
  3. Prostatitis
  4. Urethritis

Frequent causes of pyuria

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36
Q

Clinical Significance of Neutrophils in Urine

What are the non-bacterial disorders associated with WBCs in urine?

Familiarize pa ulit hehe.

A
  1. Glumerolonephritis
  2. Lupus erythematosus
  3. Interstitial nephritis
  4. Tumors
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37
Q

These types of WBCs are not normally seen in the urine.

A

Eosinophils

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38
Q

T or F: The finding of more than 1% eosinophils is considered significant.

A

T

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39
Q

What is the preferred stain for eosinophil?

A

Hansel Stain

40
Q

T or F: Wright’s Stain cannot be used for eosinophils.

A

F

41
Q

What is the composition of Hansel stain?

A

Methylene blue in Eosin Y

42
Q

The percentage of eosinophils in ____ to 500 cells is determined.

A

100

43
Q

Clinical Significance of Eosinophils in Urine

What is the presence of eosinophils in urine primarily associated with?

A

Associated with hypersensitivity to drugs like penicillin (drug-induced interstitial nephritis

44
Q

Clinical Significance of Eosinophils in Urine

What are the other clinical significances?

Familiarize ulit mwa.

A
  1. UTI and Renal Transplant Rejection (small numbers)
  2. Tubulointerstitial disease
45
Q

These types of WBCs may be seen in increased numbers in the early stages of renal transplant rejection.

A

Mononuclear cells

46
Q

What is the primary concern in the identification of WBCs?

A

The differentiation of mononuclear cells and disintegrating neutrophils from round RTE cells

47
Q

WBCs differ from RTE cells in such a way that?

A

RTE cells are usually larger with an eccentrically located nucleus

48
Q

T or F: WBCs in the process of ameboid motion is difficult to distinguish from epithelial cells because of their irregular shapes.

A

T

49
Q

T or F: It is not unusual to find epithelial cells in the urine.

A

T

50
Q

Why is it not unusual to find epithelial cells in the urine?

A

Because they are derived from the linings of the genitourinary system

51
Q

Largest cells found in the urine

A

Epithelial cells

52
Q

What are the different types of epithelial cells found in urine?

A
  1. Squamous
  2. Transitional (Urothelial)
  3. Renal Tubular
53
Q

What are the sites of origin of the renal tubular epithelial cells?

A

PCT, DCT, collecting duct

54
Q

What are the sites of origin of the transitional epithelial cells?

A

upper 2/3 of the urethra pelvis, bladder, upper urethra

55
Q

What are the sites of origin of the squamous epithelial cells?

A

lower 1/3 of the urethra, vulva, vagina

56
Q

Most frequently seen and least significant epithelial cell

A

Squamous Epithelial Cell

57
Q

Epithelial Cells

Large cells with abundant cytoplasm and small round central nucleus

A

Squamous Epithelial Cell

58
Q

Average size of the squamous epithelial cell?

A

40 to 60 um

59
Q

Epithelial Cell

Originate from the linings of the vagina and female urethra
and the lower portion (distal 1/3) of the male urethra

A

Squamous Epithelial Cell

60
Q

Epithelial Cells

Indicative of vaginal infection by the bacterium Garnerella vaginalis

A

Clue Cells

61
Q

Squamous Epithelial Cellls

To be considered a clue cell, the bacteria should?

Clue: It gives the cell a granular, irregular appearance.

A

Should cover most of the cell surface and extend beyond the edges of the cell

62
Q

This epithelial cell originates from the lining of the renal pelvis, bladder, ureters, and upper urethra

A

Transitional (Uroepithelial) Cells

63
Q

Average size of transitional epithelial cells?

A

20 to 40 um

64
Q

T or F: Squamous epithelial cells are larger than transitional epithelial cells

A

True

65
Q

How would you describe the shape of transitional epithelial cells?

A

Round or pear-shaped contour or tail-like projections

This called caudate epithelial cells

66
Q

What causes the differences of squamous epithelial cell and transitional epithelial cell?

A

The ability of transitional epithelial cells to absorb large amounts of water

67
Q

All forms of transitional epithelial cells have?

A

Distinct, centrally located nuclei, sometimes binucleated

68
Q

Transitional epithelial cells usually present in small numbers in normal urine representing what?

A

Normal cell sloughing

69
Q

Clinical Significance of Transitional Epithelial Cells

What are the clinical significances of transitional epithelial cells?

Familiarize yourselves mwa.

A
  1. Present in invasive urologic procedures lie catheterization (of no clinical significance)
  2. Indicative of malignancy or viral infection (if they have abnormal morphology)
  3. Transitional Cell Cancer (if in large clumps)
70
Q

Epithelial Cells

Most significant of the epithelial cells in urine

A

Renal Tubular Epithelial Cells

71
Q

T or F: RTE cells vary in size and shape depending on the area of renal tubules from which they originate.

A

True the fire

71
Q

What are the three types of RTE cells?

Clue: Depends sa site of origin

A
  1. RTE from PCT
  2. RTE from DCT
  3. RTE from the collecting duct
72
Q

Types of RTE Cells

Larger than the other RTE cells

A

RTE from PCT

73
Q

Types of RTE Cells

They are rectangular, columnar, or convulated in shape

A

RTE from PCT

74
Q

Types of RTE Cells

  • Cytoplasm is coarsely granular, and the RTE cells often resemble casts
  • Resemble granular or fatty casts
A

RTE from PCT

75
Q

Types of RTE Cells

  • Occurs singly (14-60um)
  • Smaller than those from the PCT
A

RTE from DCT

76
Q
  • Round or oval (oblong or egg-shaped) cells with coarse granules
  • Can be mistaken for WBCs and spherical transitional
    epithelial cells
A

RTE from DCT

77
Q

Types of RTE Cells

  • Cuboidal or polygonal
  • Has the presence of at least one straight edge which differentiated them from the other RTEs
  • Nucleus occupies 60 to 70% of the cells
A

RTE from the collecting duct

78
Q

RTE from the collecting duct

When appearing in groups of three or more, they are called what?

A

Renal fragments

79
Q

RTE from the collecting duct

RTEs from the collecting duct are often seen as?

A

Large sheets of cells

80
Q

What are the normal values of RTE cells in urine?

A

0-2/hpf

81
Q

Clinical Significances of RTE

What are the clinical significances of RTE cells in urine?

Di ko na lalagay yung conditions that produce tubular necrosis or tubular damage, just read it sa transes hehe.

A
  1. Indicative of necrosis of renal tubules
  2. Secondary effects of glomerular disorders
  3. Indication of severe tubular injury with basement disrubtion
  4. Salicylate poisoning (single cuboidal cells)
82
Q

T or F: It is unusual for RTE cells to contain substances from the filtrate.

A

F

Their function is reabsorption of the glomerular filtrate kaya di siya unusual.

83
Q

T or F: RTE cells absorb bilirubin present in the filtrate.

A

T

84
Q

Lipid-containing RTE cells

A

Oval Fat Bodies

85
Q

RTE Cells

  • Appear highly refractile
  • The nucleus may be more difficult to observe
  • Usually seen in conjunction with free-floating fat droplets
A

Oval Fat Bodies

85
Q

T or F: RTE cells absorb lipids that are present in glomerular filtrate.

A

T

86
Q

Identification of Oval Fat Bodies

What stain is used for oval fat bodies?

A

Sudan III or Oil Red O fat stains

87
Q

Identification of Oval Fat Bodies

What are the compositions of the droplets?

A

Triglycerides
Neutral Fats
Cholesterol

88
Q

Identification of Oval Fat Bodies

The fat stains stain the triglycerides and neutral fats as what color?

A

Orange-red

89
Q

Identification of Oval Fat Bodies

Examining the sediments is possible through the use of?

A

Polarized microscopy

90
Q

Identification of Oval Fat Bodies

Polarized microscopy allows for the appearance of?

A

Maltese cross formations in droplets containing cholesterol

91
Q

Oval Fat Bodies

  • Most frequently associated with damage to the glomerulus caused by the nephrotic syndrome
  • Also seen with severe tubular necrosis, diabetes mellitus, and in trauma cases that cause release of bone marrow fat from the long bones
A

Lipiduria

92
Q

In what cases are RTE cells containing large, nonlipid-filled vacuoles observed?

A

Acute tubular necrosis

93
Q

They are RTE cells that contain large, non-lipid vacuoles

A

Bubble Cells

94
Q

Appear to represent injured cells in which the endoplasmic reticulum has dilated prior to cell death

A

Bubble Cells

95
Q

If you see this card

A

Please send Shen a photo of Jeon Wonwoo <3

AUBF (34 decks)

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